title: Prognostic factors in patients with acute liver failure undergoing live donor liver transplantation.
abstract: Mortality from acute liver failure (ALF) is high. Live donor liver transplantation (LDLT) is the treatment of choice for ALF in Asia, because cadaveric donors are rare. We sought to review our results in ALF patients with undergoing LDLT at our center. One hundred two LDLTs were performed at our center from April 2002 to November 2007, 15 (14%) because of ALF. Mean (SEM; median, range) follow-up was 1,065 (189; 1400; 3-2046) days. Nine patients (60%) had acute exacerbation of chronic hepatitis B; and 6 (40%) had drug-induced liver injury. Age was 47 (3; 50; 27-65) years. Ten patients (67%) were men. At transplantation, laboratory values were included bilirubin, 449 (35) micromol/L; creatinine concentration, 182 (32) mmol/L. The international normalized ratio was 2.4 (0.2). The Model for End-Stage Liver Disease (MELD) score was 34 (2). Both inpatient and long-term mortality was 20% 3 of 15 patients died. The 5-year survival was 80%. Compared with survivors, patients who died had a significantly higher creatinine concentration 289 vs 155 micromol/L, international normalized ratio (3.4 vs 2.1), MELD score (47 vs 32). We conclude that despite being sick with median and mean MELD scores of 32 and 34, 80% of patients with ALF can achieve good long-term survival after LDLT.
authors.affiliation: Asian Center for Liver Diseases and Transplantation, Singapore.
authors.forename: H
authors.initials: H
authors.lastname: Rajekar
authors.forename: C T
authors.initials: CT
authors.lastname: Wai
authors.forename: T A
authors.initials: TA
authors.lastname: Majeed
authors.forename: K H
authors.initials: KH
authors.lastname: Lee
authors.forename: S Y
authors.initials: SY
authors.lastname: Wong
authors.forename: S O
authors.initials: SO
authors.lastname: Leong
authors.forename: R
authors.initials: R
authors.lastname: Singh
authors.forename: K H
authors.initials: KH
authors.lastname: Tay
authors.forename: C
authors.initials: C
authors.lastname: Soosaynathan
authors.forename: K C
authors.initials: KC
authors.lastname: Tan
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D008099:Liver / Q000187:drug effects / Q000293:injuries; D017114:Liver Failure, Acute / Q000601:surgery*; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000401:mortality / Q000502:physiology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D017741:Survivors
chemical_list: D003404:Creatinine